Table 1

Characteristics of randomised controlled trials of lifestyle interventions for weight gain in psychosis
Study (year) Sample size Participants/ setting Diagnosis Antipsychotic medication Primary outcomes Intervention Control Duration* Followup**
Álvarez Jiménez et al. (2006) [15] (a) 28 Outpatients Schizophrenia, schizophreniform disorder, schizoaffective disorder, delusional disorder, brief reactive psychosis, or psychosis not otherwise specified (NOS) Olanzapine, risperidone, haloperidol - Body weight 10 to 14 individual sessions (weight check, agenda setting, review of self monitoring records, homework assignments) provided by clinical psychologists Usual care +  nonstructured information about weight gain and encouragement to limit food intake and/or increase physical activity 12 0
(b) 33 - BMI change
- Percentage of patients whose weight increased by more than 7 % of the initial weight
Brar et al. (2005) [13] (a) 35 Outpatients or stable long-term inpatients Schizophrenia (38), Schizoaffective disorder (33) Risperidone Body weight change 20 group-based behavioural treatment sessions for weight loss (manual driven didactic programme) Usual care 14 0
(b) 37 Concomitant medications: sedative-hypnotics, antidepressants
Brown & Smith (2009) [29] (a) 15 Outpatients Schizophrenia (11), bipolar disorder (5), depression (9), borderline personality disorder (3) Weight gain drugs (not specified) Body weight change 5 semistructured health promotion sessions using an operational manual based on motivational interviewing, education, diary keeping, and facilitation of access to mainstream facilities, facilitated by mental health key workers Usual care N/A 0
(b) 11
Evans et al. (2005) [14] (a) 29 Outpatients Schizophrenia (16), Schizoaffective disorder (11), schizophreniform psychosis (10), bipolar disorder (8), depression (5) Olanzapine - Body weight 6 individual nutritional education sessions conducted by an accredited practicing dietician Passive nutritional education from the booklet “Food for the mind” 12 12
(b) 22 - BMI change
- Waist circumference change
Forsberg et al. (2008) [27] (a) 27 Supported housing facilities Schizophrenia (23), bipolar disorder (3), other psychotic disorders (7), other psychiatric diagnoses (8) Antipsychotic medication - Weight Programme for healthy living: 2 sessions weekly focusing on the cooking of good nourishing food and on physical activity (indoor and outdoor activities) lead by a circle leader (no training in mental health field and no own experience of working with person with psychiatric disabilities but has a personal interest in healthy food and experience as a fitness instructor) “aesthetic study circle” (learn and practice artistic techniques) 52 0
(b) 19 - Waist
- Physiological values
Khazaal et al. (2007) [20] (a) 31 Outpatients Schizophrenia and schizoaffective disorders (73.8 %), bipolar disorder (8.2 %), schizotypal disorder (6.6 %), other (11.5 %) Olanzapine, risperidone, clozapine, quetiapine, amisulpride, classical antipsychotics - Body weight 12 2-hour group sessions weekly (motivational interview), tasting sessions, psychoeducation on links between weight gain and antipsychotics, food intake moderation prescribed, provided by two psychologists Brief Nutritional Education (one informative 2 hour group session) 12 3
(b) 30 - BMI

- Eating and weight-related cognitions (MAC-R)

- Binge eating simptomatology (SCID-IV)

Kwon et al. (2006) [16] (a) 33 Outpatients Schizophrenia or schizoaffective disorder Olanzapine - Body weight Diet and exercise management programme based on cognitive and behavioural therapy, nutritional education, diary and exercise lead respectively by a dietician and an exercise coordinator Usual care +  recommendations as to physical activity and eating 12 0
(b) 15 - BMI
Littrell et al. (2003) (a) 35 Outpatients Schizophrenia (54), schizoaffective disorder (16) Olanzapine - Body weight 16 1-hour psychoeducation classes using the "Solutions of wellness" modules ("Nutrition, wellness and living a healthy lifestyle", "Fitness and exercise") held by a clinician Usual care +  olanzapine 16 8
(b) 35 Concomitant medications: lithium, valproate, SSRI - BMI
Mauri et al. (2008) [28] (a) 21 Outpatients Bipolar I disorder (41), bipolar II disorder (2), depressive disorder with psychotic symptoms (1) Olanzapine - Body weight dietary group programme for weight control: 30-minutes psychoeducational meetings + diet N/A 12 0
(b) 27 - BMI
McKibbin et al. (2006) [17] (a) 32 Board-and-care and community clubhouse Schizophrenia (48), schizoaffective disorder (9) Antipsychotics - Body weight 24 weekly, 90 min sessions addressing diabetes education, nutrition, and lifestyle exercise conducted by healthcare providers, dieticians, and diabetes educators Usual care +  3 brochures from American Diabetes Association 24 0
(b) 32 - BMI
- Waist circumference change
Milano et al. (2007) [26] (a) 22 Outpatients Schizophrenia or manic episodes in bipolar disease Olanzapine - Body weight change Psychoeducational programme with information on correct alimentary practices and personal health; diet (reduction of 500 kcal/ die); programme on physical exercise (3/wk, 30-60 min) Regular diet, no physical activity 8 0
(b) 14
Weber & Wyne (2006) [19] (a) 8 Outpatients Schizophrenia or schizoaffective disorder One oral atypical antipsychotic - Body weight 1-hour group session based on cognitive- behavioural strategies to promote risk reduction (with food and activity diary) provided by a trained psychiatric nurse practitioner supervised weekly Usual care 16 16
(b) 9 - BMI

- Waist-hip ratio

- Blood glucose level

Wu et al. (2007) [21] (a) 28 Hospitalized patients Schizophrenia Clozapine - Body weight Dietary control by a registered dietician. 1-hour physical activity sessions 3 times a week N/A 24 0
(b) 28 - BMI
- Body fat
- Waist-hip ratio

(a) experimental group.

(b) control group.

*number of weeks.

**follow-up assessment, number of weeks after the end of intervention.

Bonfioli et al.

Bonfioli et al. BMC Psychiatry 2012 12:78   doi:10.1186/1471-244X-12-78

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